10248. Special. Package # 551.2 (Albumin, creatinine, albumin-creatinine ratio, urine)

Package No. 551.2 assesses the presence and degree of albuminuria – the excretion of the protein albumin in the urine, which is a sensitive early marker of glomerular damage. It includes:

• Urine albumin.
• Urine creatinine.
• Albumin-to-creatinine ratio (ACR) – the most informative indicator for screening early stages of nephropathy.

Albumin is a low-molecular-weight protein that normally circulates in the blood and performs important functions: maintaining oncotic pressure and transporting hormones, fatty acids, and drugs. In healthy individuals, the glomeruli of the kidneys retain almost all albumin, and its release into the urine is minimal (less than 30 mg/day).

The presence of albumin in urine at higher concentrations (30 to 300 mg/day) is called microalbuminuria and is one of the first clinical markers of impaired glomerular filtration function in the kidneys.

Long-term microalbuminuria typically indicates the early stages of kidney damage associated with chronic diseases such as diabetes or hypertension. If left undiagnosed and untreated at this stage, microalbuminuria can progress to proteinuria (>300 mg/day), which is a sign of more significant kidney damage.

Creatinine is a product of creatine metabolism, which is formed in muscle and is steadily excreted by the kidneys.

When assessing albuminuria, measuring urinary creatinine levels helps compensate for the effects of hydration (dilution or concentration of urine). Therefore, calculating the albumin-to-creatinine ratio (ACR) is considered more reliable than measuring albumin alone in a single urine sample.

The albumin-to-creatinine ratio (ACR) – the ratio of albumin to creatinine – is the gold standard for detecting occult nephropathy without the need for a 24-hour urine collection.

According to current guidelines (KDIGO, 2020), the ACR allows for:

• accurate detection of microalbuminuria;
• assessing the extent of kidney damage;
• predicting the risk of developing chronic kidney disease (CKD), cardiovascular events, and the progression of diabetic nephropathy.

When?

• During annual screening of patients with type 1 and type 2 diabetes.
• As part of the diagnosis and monitoring of hypertension.
• After proteinuria is detected in a urinalysis.
• If diabetic or hypertensive nephropathy is suspected.
• To evaluate the effectiveness of therapy with RAAS inhibitors (e.g., ACE inhibitors).

Who?

• Patients with any type of diabetes.
• Patients with hypertension, especially if the disease has lasted for >5 years.
• Patients with cardiovascular disease or metabolic syndrome.
• Patients with a family history of chronic kidney disease.
• Patients with impaired renal function, edema, or abnormal urinalysis results.

• Urine

Thorough cleaning of the external genitalia: